Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Eur J Public Health. 2023 Aug 1;33(4):585-590. doi: 10.1093/eurpub/ckad100.
To improve health, intersectoral cooperation is often advocated. However, only few studies have reported health effects of this approach. Sweden has adopted a national public health policy (NPHP), which focuses on intersectoral primary prevention of disorders and injuries.
To investigate the effects of the NPHP, on child and adolescent health in Sweden during the period 2000-19.
In the first step, the most important improvements in disorders and injuries, assessed as DALYs and incidences, were identified using the GBD Compare database. In the second step, primary prevention methods for these disorders and injuries were identified. In the third step, the relative importance of various government agents for these preventive measures was assessed using Google searches.
Out of 24 groups of causes of disease or injury, only two groups demonstrated an incidence decrease: neoplasms and transport injuries. Leukaemia neoplasms might be prevented by reducing parental smoking, reducing outdoor air pollution and having the mother take folate supplements before getting pregnant. Transport injuries might be prevented by speed restrictions, and physically separating pedestrians from vehicle transport. Most of the primary prevention work was done by government agencies, like the Swedish Transport Agency, which worked independently of the National Institute of Public Health.
Governmental agencies outside the health carried out most of the effective primary preventive efforts, almost independently of the NPHP.
为了增进健康,通常提倡部门间合作。然而,仅有少数研究报告了这种方法对健康的影响。瑞典采取了国家公共卫生政策(NPHP),该政策侧重于针对疾病和伤害的部门间初级预防。
调查瑞典 NPHP 对儿童和青少年健康的影响,时间跨度为 2000 年至 2019 年。
第一步,使用 GBD Compare 数据库,确定疾病和伤害方面最重要的改进,评估方法为 DALY 和发病率。第二步,确定这些疾病和伤害的初级预防方法。第三步,使用谷歌搜索评估各个政府机构对这些预防措施的相对重要性。
在 24 组疾病或伤害原因中,只有两组显示发病率下降:肿瘤和交通伤害。通过减少父母吸烟、减少室外空气污染和让母亲在怀孕前服用叶酸补充剂,可以预防白血病肿瘤。通过限速和将行人和车辆运输物理隔离,可以预防交通伤害。大部分初级预防工作由政府机构完成,如瑞典交通管理局,其工作独立于国家公共卫生研究所。
除卫生部门外的政府机构开展了大部分有效的初级预防工作,几乎独立于 NPHP。